The Molecular Genetics and Cellular Mechanisms Underlying Pulmonary Arterial Hypertension

Pulmonary arterial hypertension (PAH) is an incurable disorder clinically characterised by a sustained elevation of mean arterial pressure in the absence of systemic involvement. As the adult circulation is a low pressure, low resistance system, PAH represents a reversal to a foetal state. The small...

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Main Author: Rajiv D. Machado
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Scientifica
Online Access:http://dx.doi.org/10.6064/2012/106576
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author Rajiv D. Machado
author_facet Rajiv D. Machado
author_sort Rajiv D. Machado
collection DOAJ
description Pulmonary arterial hypertension (PAH) is an incurable disorder clinically characterised by a sustained elevation of mean arterial pressure in the absence of systemic involvement. As the adult circulation is a low pressure, low resistance system, PAH represents a reversal to a foetal state. The small pulmonary arteries of patients exhibit luminal occlusion resultant from the uncontrolled growth of endothelial and smooth muscle cells. This vascular remodelling is comprised of hallmark defects, most notably the plexiform lesion. PAH may be familial in nature but the majority of patients present with spontaneous disease or PAH associated with other complications. In this paper, the molecular genetic basis of the disorder is discussed in detail ranging from the original identification of the major genetic contributant to PAH and moving on to current next-generation technologies that have led to the rapid identification of additional genetic risk factors. The impact of identified mutations on the cell is examined, particularly, the determination of pathways disrupted in disease and critical to pulmonary vascular maintenance. Finally, the application of research in this area to the design and development of novel treatment options for patients is addressed along with the future directions PAH research is progressing towards.
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spelling doaj-art-42bb19e8d432407db64c01715bf66ffc2025-02-03T05:43:45ZengWileyScientifica2090-908X2012-01-01201210.6064/2012/106576106576The Molecular Genetics and Cellular Mechanisms Underlying Pulmonary Arterial HypertensionRajiv D. Machado0School of Life Sciences, Faculty of Science, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, UKPulmonary arterial hypertension (PAH) is an incurable disorder clinically characterised by a sustained elevation of mean arterial pressure in the absence of systemic involvement. As the adult circulation is a low pressure, low resistance system, PAH represents a reversal to a foetal state. The small pulmonary arteries of patients exhibit luminal occlusion resultant from the uncontrolled growth of endothelial and smooth muscle cells. This vascular remodelling is comprised of hallmark defects, most notably the plexiform lesion. PAH may be familial in nature but the majority of patients present with spontaneous disease or PAH associated with other complications. In this paper, the molecular genetic basis of the disorder is discussed in detail ranging from the original identification of the major genetic contributant to PAH and moving on to current next-generation technologies that have led to the rapid identification of additional genetic risk factors. The impact of identified mutations on the cell is examined, particularly, the determination of pathways disrupted in disease and critical to pulmonary vascular maintenance. Finally, the application of research in this area to the design and development of novel treatment options for patients is addressed along with the future directions PAH research is progressing towards.http://dx.doi.org/10.6064/2012/106576
spellingShingle Rajiv D. Machado
The Molecular Genetics and Cellular Mechanisms Underlying Pulmonary Arterial Hypertension
Scientifica
title The Molecular Genetics and Cellular Mechanisms Underlying Pulmonary Arterial Hypertension
title_full The Molecular Genetics and Cellular Mechanisms Underlying Pulmonary Arterial Hypertension
title_fullStr The Molecular Genetics and Cellular Mechanisms Underlying Pulmonary Arterial Hypertension
title_full_unstemmed The Molecular Genetics and Cellular Mechanisms Underlying Pulmonary Arterial Hypertension
title_short The Molecular Genetics and Cellular Mechanisms Underlying Pulmonary Arterial Hypertension
title_sort molecular genetics and cellular mechanisms underlying pulmonary arterial hypertension
url http://dx.doi.org/10.6064/2012/106576
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